Bergauer Lisa, Akbas Samira, Braun Julia, Ganter Michael T, Meybohm Patrick, Hottenrott Sebastian, Zacharowski Kai, Raimann Florian J, Rivas Eva, López-Baamonde Manuel, Spahn Donat R, Noethiger Christoph B, Tscholl David W, Roche Tadzio R
Institute of Anaesthesiology, University Hospital Zurich, 8091 Zurich, Switzerland.
Departments of Epidemiology and Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland.
Bioengineering (Basel). 2023 Mar 8;10(3):340. doi: 10.3390/bioengineering10030340.
Interpreting blood gas analysis results can be challenging for the clinician, especially in stressful situations under time pressure. To foster fast and correct interpretation of blood gas results, we developed Visual Blood. This computer-based, multicentre, noninferiority study compared Visual Blood and conventional arterial blood gas (ABG) printouts. We presented six scenarios to anaesthesiologists, once with Visual Blood and once with the conventional ABG printout. The primary outcome was ABG parameter perception. The secondary outcomes included correct clinical diagnoses, perceived diagnostic confidence, and perceived workload. To analyse the results, we used mixed models and matched odds ratios. Analysing 300 within-subject cases, we showed noninferiority of Visual Blood compared to ABG printouts concerning the rate of correctly perceived ABG parameters (rate ratio, 0.96; 95% CI, 0.92-1.00; = 0.06). Additionally, the study revealed two times higher odds of making the correct clinical diagnosis using Visual Blood (OR, 2.16; 95% CI, 1.42-3.29; < 0.001) than using ABG printouts. There was no or, respectively, weak evidence for a difference in diagnostic confidence (OR, 0.84; 95% CI, 0.58-1.21; = 0.34) and perceived workload (Coefficient, 2.44; 95% CI, -0.09-4.98; = 0.06). This study showed that participants did not perceive the ABG parameters better, but using Visual Blood resulted in more correct clinical diagnoses than using conventional ABG printouts. This suggests that Visual Blood allows for a higher level of situation awareness beyond individual parameters' perception. However, the study also highlighted the limitations of today's virtual reality headsets and Visual Blood.
对临床医生而言,解读血气分析结果可能具有挑战性,尤其是在时间紧迫的压力情况下。为促进对血气结果的快速且正确解读,我们开发了“可视化血液”软件。这项基于计算机的多中心非劣效性研究比较了“可视化血液”软件和传统动脉血气(ABG)打印结果。我们向麻醉医生展示了六种临床场景,一次使用“可视化血液”软件,一次使用传统ABG打印结果。主要结局是对ABG参数的认知。次要结局包括正确的临床诊断、感知到的诊断信心以及感知到的工作量。为分析结果,我们使用了混合模型和匹配优势比。通过分析300例受试者内部的病例,我们发现与ABG打印结果相比,“可视化血液”软件在正确感知ABG参数的比率方面具有非劣效性(率比为0.96;95%置信区间为0.92 - 1.00;P = 0.06)。此外,研究显示使用“可视化血液”软件做出正确临床诊断的几率比使用ABG打印结果高出两倍(优势比为2.16;95%置信区间为1.42 - 3.29;P < 0.001)。在诊断信心方面没有差异的证据,或者分别有微弱证据表明存在差异(优势比为0.84;95%置信区间为0.58 - 1.21;P = 0.34),以及在感知工作量方面(系数为2.44;95%置信区间为 - 0.09 - 4.98;P = 0.06)。这项研究表明,参与者对ABG参数的感知并没有更好,但使用“可视化血液”软件比使用传统ABG打印结果能做出更多正确的临床诊断。这表明“可视化血液”软件除了能感知单个参数外,还能实现更高水平的态势感知。然而,该研究也凸显了当今虚拟现实头戴设备和 “可视化血液”软件的局限性。